合并颅脑伤的腹闭合伤早期诊断

Early diagnosis of closed abdominal injury with head injury

目的 :提高合并颅脑伤的闭合性腹部损伤早期诊断率。方法 :回顾总结 42例闭合性腹部损伤合并颅脑伤患者的资料 ,其中 16例超过就诊 6小时后获得腹内脏器损伤诊断列为延迟组 (A组 ) ,2 6例在 6小时内获得诊断列为对照组 (B组 )。结果 :A组车祸坠落伤高 (P<0 .0 5 ) ,颅脑损伤重 (P<0 .0 5 ) ;入院时休克、腹部症状及体征表现、诊断性腹穿阳性率均低于对照组 (P<0 .0 5 )。结论 :提高早期诊断率要加强多发性损伤认识 ,把握合并颅脑伤的闭合性腹部损伤特点 ,密切观察病情变化 。

Objective: It is to increase the accuracy of early diagnosis of closed abdominal injury with head injury.Methods: 42 closed abdominal injured patients with head injury who admitted to the hospital from January 1986 to December 1999 were analyzed retrospectively, 16 cases which were diagnosed organs injury in abdomen after 6 hours of visit belong to delayed group (group A), 26 cases which were diagnosed in 6 hours of visit was control group (group B).Results: The rate of wounds from drop and traffic in group A was higher than that in group B (P<0.05), and the head injury as well (P<0.05). To these patients who were admitted to the hospital, the morbidity of shock, the abdominal symptoms and signs and the positive rate of abdominocentesis all were lower (P<0.05). Conclusion: In order to increase early diagnosis accuracy, doctors should to enhance the cognition of multiple trauma, to study the clinical features of closed abdominal injury with head trauma, to see carefully changes of patients` condition and to use physical examination and test.